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October 1950, Vol 61, No. 4 >
ARTICLE | October 1950

MIDDLE LOBE SYNDROME

FRED R. HARPER, M.D.; WILLIAM B. CONDON, M.D.; WILLIAM H. WIERMAN, M.D.
AMA Arch Surg. 1950;61(4):696-704. doi:10.1001/archsurg.1950.01250020702010.
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CHRONIC nonspecific pneumonitis with atelectasis occurring in the middle lobe of the right lung has recently been classified as a clinical entity and been called "middle lobe syndrome." Graham, Burford and Mayer1 and also Paulson and Shaw2 have called attention to the lesion. These authors feel that the characteristic pattern of this type of suppuration justifies its separation into a clinical entity. They have mentioned that enlargement of peribronchial lymph nodes has been common in their cases. They emphasize the nonspecific nature of the disease.

We have reviewed our cases of chronic suppurative pulmonary disease to see if there was a characteristic group of symptoms, pathologic picture or roentgen shadow common to all the cases of pneumonitis of the middle lobe. We were unable to find a correlated clinical and pathologic entity peculiar to the middle lobe. We did, however, find 26 patients in whom we felt that

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